<!DOCTYPE html>
<html>
<meta http-equiv="Content-Type" content="text/html;charset=utf-8"/>

<head>
    <title>信息收集</title>
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <style>
        body {
            font-family: Arial, sans-serif;
            background-color: #f2f2f2;
            margin: 0;
            padding: 20px;
        }

        h1 {
            text-align: center;
        }

        form {
            max-width: 500px;
            margin: 0 auto;
            background-color: #fff;
            padding: 20px;
            border-radius: 5px;
            box-shadow: 0 2px 5px rgba(0, 0, 0, 0.1);
        }

        label {
            display: block;
            font-weight: bold;
            margin-bottom: 5px;
        }

        input[type="text"],
        input[type="email"],
        textarea {
            width: 100%;
            padding: 10px;
            border: 1px solid #ccc;
            border-radius: 4px;
            box-sizing: border-box;
            margin-bottom: 10px;
        }

        textarea {
            height: 80px;
        }

        select {
            width: 100%;
            height: 40px;
            padding: 5px;
            border: 1px solid #ccc;
            border-radius: 4px;
            box-sizing: border-box;
            margin-bottom: 10px;
        }

        input[type="submit"] {
            background-color: #4CAF50;
            color: #fff;
            border: none;
            padding: 10px 20px;
            border-radius: 4px;
            cursor: pointer;
        }

        input[type="submit"]:hover {
            background-color: #45a049;
        }
    </style>
</head>
<body>
<h1>信息收集</h1>

<form>
    <label for="merchantId">商户编号:</label>
    <input type="text" id="merchantId" name="merchantId" required>

    <label for="merchantName">商户名字:</label>
    <input type="text" id="merchantName" name="merchantName" required>

    <label for="contactPerson">联系人:</label>
    <input type="text" id="contactPerson" name="contactPerson" required>

    <label for="contactPhone">联系人手机:</label>
    <input type="text" id="contactPhone" name="contactPhone" required>

    <label for="contactEmail">联系人邮箱:</label>
    <input type="email" id="contactEmail" name="contactEmail" required>

    <label for="selectField">修改资料项目:</label>
    <select id="selectField" name="selectField">
        <option value="full_name">全称</option>
        <option value="abbreviation">简称</option>
        <option value="address">地址</option>
        <option value="business_license">营业执照</option>
        <option value="settlement_account">结算账号</option>
    </select>

    <label for="originalInfo">原信息:</label>
    <textarea id="originalInfo" name="originalInfo" rows="2" required></textarea>

    <label for="newInfo">新信息:</label>
    <textarea id="newInfo" name="newInfo" rows="2" required></textarea>

    <input type="submit" value="提交">
</form>
</body>
</html>